T Nation

Sky High SHBG and LH Level

Hi all,

Got some blood tests back, been suffering from ED and low libido for years now. I am 31-years old, I’m clean, lift 4-5 times per week, only supplements I take are ZMA and multi-Vitamins.

I live in the UK, so the results are in UK measurements.

So got the results back, the doctor highlighted that my LUTEINISING HORMONE and SEX HORMONE BINDING GLOB (SHGB) are high.

In particular it seems my SHGB is very high.

He said that I should get a thyroid and liver check done too, which I am getting done this week.

TESTOSTERONE 28.2 nmol/L
FREE- TESTOSTERONE(CALCULATED) 0.32 nmol/L
SEX HORMONE BINDING GLOB 86.9 nmol/L
LUTEINISING HORMONE 9.2 IU/L

D.H.E.A. SULPHATE 11.900 umol/L
FOLLICLE STIM. HORMONE 4.24 IU/L
FREE ANDROGEN INDEX 32.45
BETA OESTRADIOL 93.6 pmol/L

Does anyone have any advice on what might be causing this? I’m really worried it might be affecting my sperm and fertility so going to get that checked now too.

Here’s an image of the results and the expected ranges.

27

Your pituitary gland is detecting low levels of free T and is attempting to compensate by increasing LH to get the testicles to produce more testosterone, SHBG is out of control and unless medication are causing it, then TRT is the only treatment that stands a chance at lowering it.

SHBG prevents testosterone from clearing out of the body quickly, in your case it’s holding on to the majority of your testosterone and not allowing much of it to be bioavailable to the body. So in effect your testosterone is low, the bioavailable testosterone. You will never see any of that total testosterone, it’s in a bound state and unavailable.

Nebido is unlikely to work as the ester is too slow acting, you need test ethanate or sustanon, large weekly doses. Not many doctors understand how the TRT game is played in the UK, or monitoring and managing estrogen. A lot who come here also have a degree of thyroid issues, doctors often too interested in the numbers rather than the symptoms.

You can check your thyroid status by checking your waking and afternoon body temperatures using an oral glass thermometer, not a digital. The results will directly reflect your thyroid status as free T3 is directly connected to your body temperatures.

Your response to TRT will be determined by thyroid levels, good free T3 and Reverse T3 below 15ng/dL should give excellent results.

Some high SHBG men require supra physiological doses to hammer down high SHBG, blood donation may be necessary to keep hematocrit under control.

Thanks for the quick reply, really helpful stuff. Will update once I get the thyroid and liver tests back.

Slightly worried now that this all seems quite serious stuff.

The doctor seemed to think none of this was major cause for concern (UNLESS the thyroid and liver tests come back with something wrong).

Keto? Intermittent fasting?

Any medications, past, present. Finasteride/procecia? Accutane?

I do eat a fairly low carb diet. Not zero carbs, but fairly low, could that be affecting my T or SHBG levels?

No intermittent fasting as such, I don’t eat breakfast but do eat a decent lunch and a big dinner.

Not medications past or present. Fit and healthy in all other means.

skipping breakfast is basically Intermittent fasting.

You stop eating after dinner and don’t eat again until lunch. Makes the body think its in starvation mode, and increases SHBG.

Also the low carb issue might be messing with it also. Start there first. Start eating carbs daily.

I tried to do “lower” carb, but I am just careful with what I choose. Good carbs, some fruit before and after working out.

Thanks, very interesting, this does kinda correlate for when my symptoms first started. I’ve been eating fairly low carbs with high protein for a few years now, which has kept me in decent shape. Hope I haven’t done any long term damage?!

So I’m still waiting for my thyroid test but I got a comprehensive blood test done with the following results.

Doctor said everything here looks very, very healthy.

Only things slightly high were BICARBONATE, CK and HDL CHOLESTEROL levels.

Can anyone spot anything that looks wrong here?

Naw, nothing permanent. Just fix up your diet see if that helps.

I was also scared of carbs because I was overweight a few times in life. Its also easy for me to gain weight.

I eat plenty of carbs though because I weight train and I NEED the energy.

Thanks alphagunner. Going to start introducing more carbs to my diet, to see if that helps at all.

Did you have a similar problem?

Also, if anyone else spots any problems with my other blood test results above please shout!

no, mine is probably high from prior alcohol/benzo abuse and a little genetics also.

I also took Accutane, so who knows. I was never an “easy” gainer.

Got my Thyroid and Liver/Kidney tests back.

Everything seems ok as far as I can tell? Any thyroid experts here?

I am one who does not place a lot of faith in “reduced carb” diets affecting SHBG. My SHBG was high when I ate a normal diet; and is still high on a reduced carb diet. I don’t eat breakfast either - and NEVER have. But, as part of my attempts to reduce my SHBG, I now eat a protein bar (NOT energy bar) every morning as “breakfast”. Has it helped? No. But I have grown used to it, and I figure the extra protein can’t hurt.

My thread is here:

My experience is limited, and anything I say is ONLY based on what I have seen in my situation. It may or may not apply to anyone else. I have had average-to-high LH & crazy-high-FSH all along because my testicles were working overtime to produce enough T to satiate the SHBG (which it was incapable of doing). Once you start TRT, they both drop to (virtual) zero.

I am still a guinea pig trying to work through the high SHBG … and continue to try new things.

Good luck.

Thanks @traveling-man going to follow your thread.

A small update.

Good-ish news

Started eating more in general, particularly carbs like brown rice and oats.

Had another blood test and my SHBG level has now dropped to 52nmol/L (previously it was 86.9 nmol/L).

My TOTAL TESTOSTERONE increased to 32nmol/L (was 28nmol/L previously), so not much change here.

I’m still outside of the normal range for SHBG, and particularly so for a 31 year old physically active male. Going to continue eating more and test again in a few months time.

Bad News
Had a fertility test and showed I have very long sperm count. Doctors think it might be linked to retractile testicles when I was young.

However, I do have sperm and the motility is very good, which is promising.

I hoping that perhaps my previous calorie restrictions and low carb diet might also have been affecting total sperm count.

Again, going to start eating more and hopefully things improve on this front too.

Anyone had similar problems before?

Hi, I’m going to hope you meant “LOW” sperm count because I don’t know what “long sperm” is. :slight_smile:

I also have low sperm count; was diagnosed 10 years ago. Interesting similarities.

did you ever get another test mate? is it still on it’s way down?